In 1997, HHS published its first strategic plan in response to the Government Performance and Results Act (GPRA). Since that time, the Department has successfully implemented the remaining GPRA requirements and now is working to continually improve the quality of its GPRA submissions. Part of that quality improvement effort has focused on updating the HHS Strategic Plan to reflect the emergence of new priorities and the experience that has been gained while implementing the initial plan. The result is an expansion and restatement of some of the Strategic Plan goals and objectives. The order of goals and objectives is much the same as in the 1997 plan and does not convey an indication of priority or the importance of one over the other. The discussion of implementation strategies also is expanded and refined. A more thorough discussion of data and management challenges and solutions is provided (Appendices D and H). A more complete analysis of external factors that might affect the goals/objectives and how the Department might mitigate them is included (Appendix B). Possible success indicators are refined and an explanation of how the strategic and annual performance plans are closely linked is now discussed in detail (Appendix C).
Additionally, with the recent release of Healthy People 2010 and the ten Leading Health Indicators, the Department has a clearly articulated set of national health objectives. The ten leading indicators relate to physical activity, overweight and obesity, tobacco use, substance (drug/alcohol) abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, and access to health care. The HHS Strategic Plan now reflects the priorities set by these national objectives. The eight objectives in Goal 1 parallel eight of the ten leading indicators; Goal 3 parallels the leading indicator on access to health care; and Objective 3.8 parallels the leading indicator on mental health.
Despite these changes, the basic logic of the plan remains the same. The strategic goals and objectives reflect Department-wide priorities that cut across individual HHS agencies and programs. In contrast, our implementation strategies are aligned with the authority and funding of categorical programs. Often, however, individuals and families have needs that go beyond the individual Department programs. For example, the person who is moving from welfare to work may also need access to affordable housing–a program that is within the purview of the Department of Housing and Urban Development (HUD). In this respect, the HHS implementation strategies for helping clients would appear to be constrained by the scope of the programs that we administer.
To overcome this constraint, HHS works with a wide range of federal, state, and local service providers to coordinate the planning and delivery of services in a way that maximizes resources and provides clients with an integrated approach to their needs. The discussion of internal and external coordination has been significantly expanded to provide a clearer sense of where the Department's programs and activities intersect with each other and with organizations outside HHS (see Appendix A).
In addition, Appendix A describes the unique service delivery partnership that we have with state and local governments, tribes, and private organizations that have programs and goals similar to those of HHS. The appendix provides a discussion of how these partnerships work in planning and delivering services and the important role that these organizations play in helping us achieve the objectives we have set in the HHS Strategic Plan.
The Department's objectives and implementation strategies target populations within our program authority (e.g., persons with particular diseases or Native Americans). Where we have discretion and are given finite resources, we target groups with the greatest needs. Beyond this, we cast our objectives and implementation strategies generically and not by particular populations, given the number of separate populations that are eligible for special services.
Planning and Assessment Cycle
Similarly, the Strategic Plan is not a depository of all actions that we might take to achieve an objective. Therefore, implementation strategies under each objective are not inclusive of everything we might do. Rather, they illustrate the general direction we plan to take. For example, a research strategy may be central to achieving one of our objectives. In this case, we would list selected research priorities to provide readers with the major thrust of our agenda and how research relates to achieving the particular objective. Listing every possible research activity would be impossible, given the number of potential research priorities that we might support.
In developing the plan, HHS consulted widely with stakeholders on the proposed revisions. The plan was posted on the web and comments solicited from employees, service delivery partners, and other stakeholders. Letters were sent to nearly 400 stakeholder organizations inviting written comment. We met with tribal and state and local government organization representatives, and held a separate meeting with the HHS Union-Management Partnership Council. We also held a general meeting open to all stakeholder organizations to provide an opportunity for discussion of the plan. The comment period yielded numerous suggestions, with input ranging from editorial to more substantive comments. Many of these were useful, and we made a number of changes to the plan based on the suggestions that we received. For example, we added a new objective on environmental health in response to stakeholder comments.